We understand that there are still “a lot of curtailments” continuing out of China even now because “The Thing” is still going on according to a note in our mailbox.

In January 2018, the SFRC’s had a Subcommittee Hearing Attacks on U.S. Diplomats in Cuba: Response and Oversight. In September 2018, Senator Bob Menendez (D-N.J.), Ranking Member of the Senate Foreign Relations Committee, sent a letter to Secretary of State Mike Pompeo requesting that the Trump administration provide an unclassified version of the State Department’s recent Accountability Review Board (ARB) report on the incidents affecting the health of U.S. personnel serving in Cuba. We have not been able to locate any congressional oversight hearings on the incident in China. We don’t know if there is an ARB China. If an ARB was convened on the health attacks in China, there does not appear to be any public notification.

In late October, an NBC News investigation indicates that US diplomats are concerned that the State Department is down-playing a pattern of what’s been called “health attacks” on diplomatic staff in Cuba and China. (see Is @StateDept Working to Minimize the Health Attacks in China? #Cuba #MissingARBs). If curtailments are still going on, that indicates that USG employees and family members in one of our largest overseas missions remain in harm’s way, so who’s talking about it? Somebody please ask your friendly senior administration official what are they doing about it. Three years ago, we would have had back to back congressional hearings not just on the Havana Syndrome, but also on the China Syndrome, and on the State Department’s response to these attacks. Can we please have some oversight hearings in January, pretty please?

Well, the "Thing" was named that way for a reason. Leon Theremin was a genius and he invented a very clever spying device. Sadly, most people still believe that "microwave spying" is science fiction. https://t.co/aCj7zyCvth

This one about Canadian diplomats and their families. G&M reports that nine Canadian adults and four children have been diagnosed with the brain injuries. “The Canadians who were affected in 2017 are all in Canada and still employed by Global Affairs, although several are unable to work because of their symptoms.”

NBC News also reviewed hundreds of pages of medical records of U.S. government workers evacuated from both Cuba and China, including those the U.S. has “medically confirmed” were attacked and those it ultimately said were not.
[…]

Most of the American diplomatic evacuees have improved enough to resume work, State Department officials said. Some have been granted accommodations, such as shortened work hours, dimmed office lights or special glasses. Meanwhile, the White House National Security Council is preparing legislation to deal with gaps that Workers’ Compensation doesn’t currently cover, such as care for affected spouses or pay-outs for permanent impairment of the brain.

In internal State Department instructions reviewed by NBC News, workers in Cuba and China were told not to discuss what they knew with the public, with reporters or on social media.
[…]

In May, Pompeo called Werner’s case “entirely consistent” with the Cuba patients. But now top U.S. diplomats say they’re not sure it’s the same thing, with one telling the House Foreign Affairs Committee it’s “apples and oranges.”

And the State Department, in explaining why it’s not setting up a review board to assess the response in Cuba, told NBC News that Pompeo didn’t believe there was enough information to prove that Werner’s injury was “related to a U.S. government mission abroad.”

Somebody please set us straight here. Wasn’t there an ARB for the Cuba attack? Or was there an ARB Havana but no ARB Guangzhou? How did State made a determination that there wasn’t enough information the injury was “related to a U.S. government mission abroad” without convening an Accountability Review Board? Did they use their Magic 8 crystal ball?

Physicians treating diplomats evacuated from #Cuba, China wouldn't speak on-record. But one recalled a patient with all the same symptoms who was "cleared." He said Penn doctors "getting thrown under the bus" by "doubting voices in the State Department." https://t.co/6I3PUgsxfs

Even more worrying is that some diplomats and doctors say the U.S. government is working to minimize what happened in China, deeming some cases that found similar conditions to those of the Cuba evacuees as “indeterminate.” https://t.co/3CBGATAeb0 (4/7) pic.twitter.com/MNPf9FvKXY

Via FSJ: James Brush, Ph.D., is a child and adolescent psychologist in private practice in Washington, D.C. He worked at the State Department as a child psychologist with the Child and Family Program division of MED Mental Health from January 2013 through March 2016. Prior to his work at State, he had a private practice in Cincinnati, Ohio, for 26 years. A past president of the Ohio Psychological Association, he continues to be involved as a committee chair.

The Child and Family Program within the Bureau of Medical Services’ Mental Health program was constituted in 2013, when the full team was finally in place after years of planning. I was brought onto the team as one of two child psychologists. By March, we had on board a child psychiatrist director, two child psychologists and three clinical social workers who had experience in treating and managing the needs of children and adolescents.

I was on the ground floor of this program, and our mission was both exciting and challenging. This was the first extensive effort within the State Department to support the specific mental health and developmental needs of children, adolescents and their families living abroad.
[…]
By 2015, three of the psychiatrists who were opposed to the CFP functioning as a comprehensive support program ended up having leadership roles in MED. Dr. Stephen Young took over as the director of mental health. Dr. Kathy Gallardo took over as deputy director of mental health, and Dr. Aleen Grabow was brought in as a child psychiatric consultant. Together, they worked toward limiting the scope of the CFP, limiting the SNEA program and reducing the opportunities for families with disabled children through more restrictive use of child mental health clearances.

Within a year of their tenure in leadership, we lost our child psychiatrist director, the two child psychologists and one clinical social worker. I and the other providers left because Drs. Young and Gallardo changed the mission and scope of the CFP. It became an unpleasant place in which to work, with the emphasis being on clearances and restricting access to SNEA. Support for families was no longer the focus. Rather, support services were being cut and the clearance process was being used to restrict the opportunities of those with disabled children.

The program is now a skeleton of what it was previously, with only one social worker, one child psychologist and one retired Foreign Service psychiatrist. Telemedicine is forbidden. The program now basically performs an administrative function, processing clearances and SNEA requests.

We understand that State/OIG is aware of some allegations related to the special needs education allowance (SNEA) and is doing “exploratory work”. Well, Dr. Brush’s account should be instructive. This is not one of the employees battling the bureaucracy on behalf of their children, this is one of the people who used to work at MED.

While we might be tempted to think that the troubling response could be some form of retaliation for blowing this issue up in the media, it is hard to imagine that MED’s policy and focus on restricting access to SNEA and the medical clearance do not have the full blessings of the State Department leadership all the way to the 7th Floor. After all, if State really wanted to resolve these cases, it would have worked with these FS families to accommodate their needs, avoid forcing people into taking loans to pay/repay for special ed needs expenses, and it would have afforded families an appeals process (IT. DOESN’T).

And they certainly would not/not have threatened people who pursue this issue, right? RIGHT?

Perhaps, this is what they mean when they talk about the new Department of Swagger? Take it or leave?

(Thought bubble: How long before the proponents of this policy get promotions, Superior Honor Awards or Presidential Rank Awards?)

While the State Department has lifted the hiring freeze, and the A-100 classes are no longer on a hit and miss schedule, it is not clear to us what the new secretary of state’s position on the previously planned 8% shrinkage of the agency workforce. If that was a WH imperative as opposed to Tillerson’s, it would be hard to imagine Secretary Pompeo going against it.

The CRS report on the Department of State, Foreign Operations and Related Programs: FY2019 Budget and Appropriations dated April 18, 2018 and updated on August 9, 2018 notes the following:

The Department of State released guidance in May 2018 lifting the hiring freeze and allowing the department to increase staffing to December 31, 2017, levels. Subsequent press reports indicate that the department intends to hire 454 new employees beyond end of year 2017 levels but also suggest that hiring must be circumscribed by previous commitments former Secretary of State Rex Tillerson made to reduce its workforce by 8%.

So this brings us to the “take it or leave” scenario for FS employees with special needs children. Since these kids are given limited medical clearances with no appeals (which precludes most if not all overseas assignments), Foreign Service families will be forced to serve either in domestic assignments in order to stay together; serve separately with employees going overseas, while their families stay in the United States, or employees may opt to pay everything out of pocket and not ask for SNEA to avoid getting snared in MED’s clutches.

Begs the questions: 1) How many career employees would stay on when their employer talk the talk about supporting FS families but know it’s just a gum chewing exercise? And 2) Is this what a slow walk to 8% looks like??

By the way, if there’s an alternate reasonable explanation for all this that does not require our relocation to the parallel universe, Earth, Too, send us an email, we’d love a good chat.

Ambassador Steve Mull Back in Foggy Bottom

In June, former Ambassador Steve Mull was appointed Acting Under Secretary for Political Affairs (P) at the State Department. Until this appointment, he was a Resident Senior Fellow at Georgetown University’s Institute for the Study of Diplomacy. Props to Secretary Pompeo for bringing him back to Foggy Bottom. Unless. a new crop of career ambassadors were nominated and confirmed while we were gone, Ambassador Mull is the last remaining career ambassador in active service as of this writing.

Still No Nominee for Director General of the Foreign Service?

So hey, it’s now July, and the U.S. Foreign Service still does not have a nominee for Director General. U.S. law dictates the nominee must be a member of the career Foreign Service.

US Ambassador to Estonia James Melville Pens Resignation on FB Over Trump Policies

On June 29, U.S. Ambassador to Estonia, Jim Melville, announced on Facebook his intent to retire from the Foreign Service after 33 years of public service. Ambassador James Desmond Melville, Jr., of New Jersey, a Career Member of the Senior Foreign Service, Class of Minister-Counselor was nominated by President Obama as U.S. Ambassador to the Republic of Estonia in the spring of 2015. He was confirmed by voice vote on August 5, 2015. Prior to his appointment in Estonia, Ambassador Melville was the Deputy Chief of Mission at the U.S. Embassy in Berlin, Germany. Previous to that, he served as Executive Director of the Bureau of European and Eurasian Affairs and the Bureau of International Organization Affairs from 2010 to 2012. Ambassador Melville also served at the U.S. Embassies in London, Moscow, Paris, and at the North Atlantic Treaty Organization in Brussels. His earlier positions with the Department of State include service as a Foreign Service Examiner, Senior Watch Officer in the Executive Secretariat Operations Center, and Legislative Management Officer in the Bureau of Legislative Affairs. Ambassador Melville received a B.A. from Boston University and a J.D. from Rutgers University. He joined the Foreign Service in 1985 during the Reagan Administration. Below via Eesti Ekspress:

Confirmations

On June 28, the U.S. Senate confirmed the following nominees:

Robin S. Bernstein, of Florida, to be Ambassador Extraordinary and Plenipotentiary of the United States of America to the Dominican Republic.

Joseph N. Mondello, of New York, to be Ambassador Extraordinary and Plenipotentiary of the United States of America to the Republic of Trinidad and Tobago.

Gordon D. Sondland, of Washington, to be Representative of the United States of America to the European Union, with the rank and status of Ambassador Extraordinary and Plenipotentiary.

Harry B. Harris, Jr., of Florida, to be Ambassador Extraordinary and Plenipotentiary of the United States of America to the Republic of Korea

Ronald Gidwitz, of Illinois, to be Ambassador Extraordinary and Plenipotentiary of the United States of America to the Kingdom of Belgium

Brian A. Nichols, of Rhode Island, a Career Member of the Senior Foreign Service, Class of Career Minister, to be Ambassador Extraordinary and Plenipotentiary of the United States of America to the Republic of Zimbabwe

Tibor Peter Nagy, Jr., of Texas, to be an Assistant Secretary of State (African Affairs)

Francis R. Fannon, of Virginia, to be an Assistant Secretary of State (Energy Resources)

On May 24, U.S. Senate confirmed the following :

James Randolph Evans, of Georgia, to be Ambassador Extraordinary and Plenipotentiary of the United States of America to Luxembourg

Jonathan R. Cohen, of California, a Career Member of the Senior Foreign Service, Class of Minister-Counselor, to be the Deputy Representative of the United States of America to the United Nations, with the rank and status of Ambassador Extraordinary and Plenipotentiary, and the Deputy Representative of the United States of America in the Security Council of the United Nations.

David B. Cornstein, of New York, to be Ambassador Extraordinary and Plenipotentiary of the United States of America to Hungary

On April 26, the U.S. Senate confirmed the following nominees:

Andrea L. Thompson, of South Dakota, to be Under Secretary of State for Arms Control and International Security

Yleem D. S. Poblete, of Virginia, to be an Assistant Secretary of State (Verification and Compliance)

Kirsten Dawn Madison, of Florida, to be an Assistant Secretary of State (International Narcotics and Law Enforcement Affairs).

Thomas J. Hushek, of Wisconsin, a Career Member of the Senior Foreign Service, Class of Minister-Counselor, to be Ambassador Extraordinary and Plenipotentiary of the United States of America to the Republic of South Sudan

Richard Grenell, of California, to be Ambassador Extraordinary and Plenipotentiary of the United States of America to the Federal Republic of Germany.

On July 2, Skydance MacMahon, 44, of Alexandria, Virginia, pleaded guilty to production of child pornography. During the time he committed these offenses, MacMahon was a Digital Media Administrator at the Foreign Services Institute of the U.S. Department of State in Arlington. According to court documents, over at least a two year period, MacMahon, 44, conspired with an adult in Canada to produce over a thousand sexually explicit images and videos of minor children in Canada. These images and videos were produced at the direction of MacMahon using Skype and hidden cameras. MacMahon distributed these image and video files to other users and consumers of child pornography by providing access to the files on his cloud storage services and also by directly sending the files to other users. In addition to the child pornography images and videos MacMahon himself created, he also received and possessed thousands of images and videos of child pornography. See more State Department Employee Pleads Guilty to Producing Child Pornography.

US Embassy London’s Inside the American Embassy Airs on Channel 4

The American Embassy, the previous TV series set at the U.S. Embassy in London in 2002 had six episodes but the show was canceled by Fox after only 4 episodes being broadcast.

On June 14, a Department of State contractor pleads guilty to theft of government funds after evidence established that he stole more than $2 million of government funds that were supposed to be transferred to a bank account maintained by the Department of State’s Global Financial Services Center in Charleston. Evidence presented at the change of plea hearing established that Mauricio Andulo Hidalgo, age 43, of Costa Rica used his position as President of SafetyPay-Central America to steal over $2,000,000 of government funds. SafetyPay-Central America had been hired as a subcontractor to handle the processing of visa application fees for the United States Embassy in Costa Rica. As part of the scheme, Hidalgo diverted the funds from a SafetyPay bank account in Costa Rica to another Costa Rican account under his sole control. See more Department of State Contractor Pleads Guilty to Theft of Government Funds.

On June 6, WaPo wrote about Mark Lenzi and his family who started noticing noises in April 2017 at the U.S. Consulate General in Guangzhou, China. “A few months later, the headaches started — pain that lasted for days at a time. Lenzi and his wife experienced the same symptoms, which soon included chronic sleeplessness as well. Lenzi says he asked his superiors for help but they dismissed his concerns. Consulate doctors prescribed painkillers and Ambien, which did nothing to address the underlying causes of the problem. And then, last month, Lenzi was shocked to learn another neighbor, a fellow Foreign Service officer, had been evacuated from their building and flown back to the United States for a thorough medical assessment, which soon determined that the person in question was suffering from “mild traumatic brain injury.”

They gave him painkillers and Ambien but medevaced the FSO next door?

The State Department reportedly issued a statement but said it is unaware of any other cases — a point “strongly disputed by Lenzi, who insists he had repeatedly informed both the embassy in Beijing and State Department headquarters in Washington of his family’s predicament.” Lenzi, who has reportedly called for the resignation of the US Ambassador to Beijing told WaPo that the State Department “restricted his access to the building where he normally worked after he began to speak up more forcefully about the treatment of his family, essentially neutralizing his capacity to continue his work at the consulate”.

We understand that Mark Lenzi is a specialist who was assigned as a Security Engineering Officer (SEO) in Guangzhou until he and his family were evacuated from post. Given the reported restriction to post access for speaking out about this incident, this is a case that bears watching.

State/ECA Official Pleads Guilty to Theft of Government Funds in Sports Visitors Program

On May 25, Kelli R. Davis, 48, of Bowie, Maryland, pleaded guilty to one count of conspiracy to commit theft of public funds and engage in honest services wire fraud before U.S. Senior District Judge T.S. Ellis III of the Eastern District of Virginia. Sentencing is scheduled for Aug. 24.

According to admissions made in connection with her plea, Davis was a Program Specialist for the State Department’s Bureau of Educational and Cultural Affairs, Office of Citizen Exchanges. She also served as the Program Manager and Grants Officer Representative for the Sports Visitors Program, which sponsored foreign exchanges for emerging youth athletes and coaches from various countries. The exchange program was managed by George Mason University in Fairfax, Virginia, through a federal grant and cooperative agreement with the State Department. See State Department Official Pleads Guilty to Honest Services Wire Fraud and Theft of Federal Funds

There were lots of talk some weeks back about people being forced to pay back special needs funding for their children that was already previously authorized and paid. Folks were wondering if MED’s Office of Child and Family Programs (MED/CFP) previously highlighted by media reporting is responsible in getting this rolling. Anybody got some special insights on the whys and hows of this?

Who owns your medical and mental health records?

It has come to our attention that the State Department’s Medical Bureau can deny/restrict employees and family members overseas assignments over erroneous entries in their medical/mental health records. Of particular note is access to mental health records. Employees can ask for an amendment to their records but how does one go about doing that without access to those records?

Apparently, State’s internal guidance doesn’t say that employees have the right to have inaccurate information removed – just that they can make the request to have it removed: “If you believe that the information we have about you is incorrect or incomplete, you may request an amendment to your protected health information as long as we maintain this information. While we will accept requests for amendment, we are not required to agree to the amendment.”

A State Department employee posted at the U.S. Consulate General in Guangzhou is reported to have some “abnormal” “sensations of sound and pressure” which is similar to those reported by personnel at U.S. Mission Cuba. We did hear about this prior to MSM reporting the incident and asked the agency’s US Asia Pacific Media Hub to connect us with Guangzhou but — you guessed it — their black hole inbox also worked really, really well, and we never heard anything back. We are pleased to see the news is out, and folks are not waiting months to react.

USCG Guangzhou is headed by Principal Officer Charles Bennett. We understand that USCG Guangzhou did a townhall for post employees/families 2-3 hours after it sent out the health alert. Another townhall was also supposed to be held on May 25 but we have not heard if that actually happened.

Via USCG Guangzhou: “Throughout the past two centuries, dating back to the presidency of George Washington, Consulate Guangzhou (Canton), as America’s oldest diplomatic post in China and one of America’s oldest posts in the Far East, has played a pivotal role in promoting America’s relationship with China. Today, the Consulate promotes trade and commercial ties, engages China across-the board on key American policy objectives, and promotes public diplomacy through visitor exchanges. The Consulate General is the only U.S. mission in China to process American adoptions and immigrant visas, making it one of the U.S. Department of State’s busiest consular-related posts.”

Note that as of May 2017, the U.S. China Mission (Embassy Beijing, and Consulates General Chengdu, Guangzhou, Shanghai, Shenyang and Wuhan) had representatives from 33 U.S. Government agencies and an authorized staff of 729 U.S. direct-hire American employees, 168 local-hire Americans and 1,807 non-American locally employed (LE) staff members.

In FY2016 Consulate General Guangzhou processed more than 54,000 immigrant visas, making it the third busiest immigrant visa unit in the world. It also had approximately 210 First and Second Tour (FAST) employees, among the largest number of any U.S. overseas mission.

According to State/OIG, Mission China’s Consular Sections provide services to a community of U.S. citizens, both residents and visitors, which the embassy estimated to be as many as 800,000 on any given day. “Factors affecting American citizen services included a growing demand for notarial services and chronic difficulties in obtaining Chinese government permission to visit the approximately 100 U.S. citizens imprisoned in China.”

An American government employee posted in Guangzhou, China has signs of possible brain injury after reporting disturbing sounds and sensations, events that seemed parallel to ailments that affected American diplomats in Cuba https://t.co/vYW9BIvlH2

China's Foreign Ministry on Thu responded to reports that a US consular employee in Guangzhou suffered abnormal sensations of sound and pressure, saying China always protects foreign diplomats and has found no evidence to support the claim. pic.twitter.com/6ljKR4EtpG

We previously blogged about the ongoing problems encountered by Foreign Service families with special needs children when dealing with the State Department’s Bureau of Medical Services (MED) (see @StateDept’s Mental Health Services Drive Employees with Special Needs #FSKids Nuts). Note that as employees prepare for the summer job rotation, MED will be reviewing the medical clearances of employees and family members in preparation for their transfer. Whatever is the number that is now stuck in MED’s labyrinth, expect that number to go up with the upcoming rotations as kids with special needs are snared in the system that is supposed to help but instead has caused so much disruption and pain.

We understand that medical clearance decisions can be appealed to a panel of three doctors. But we’ve been informed that one of the three in this review panel is the reviewing officer of the the other two. We’d like to know how many cases that come before this review panel are decided in complete agreement by all panel members, and how many cases are decided by the two panel members against the decision of the third panel member/rating official? Perhaps something for the congressional oversight panels to look into? Or something to FOIA if this is going the class action route.

Congress should also look into State’s Medical Services perspective on risk. Would it surprise us all if State/MED doesn’t want to take any? State/MED’s mission is “to safeguard and promote the health and well-being of America’s diplomatic community.” Does that mean keep everyone with the slightest issue inside the United States instead of sending them on overseas assignments? Bad things can happen just the same in the United States – but of course, MED won’t be responsible when employees are on domestic assignments. It is responsible once employees/family members are overseas. So again, what is State/MED’s perspective on risk, and how much does this inform its decision on the medical clearances issued to FS employees, spouses and their kids?

FP’s Robbie Gramer recently had a lengthy piece on FS families in State’s medical labyrinth. It is quite a read, and don’t miss the quotes.

1. What is ultrasound useful for?

The most commonly known use for ultrasound – high-frequency sound waves human ears can’t hear – is a medical device used for examining a fetus during pregnancy. But there are plenty of other uses. Many offices have occupancy sensors that use ultrasound to detect movement and keep the lights on when someone is in a space, and off when nobody is around. These sensors operate at frequencies such as 32 kilohertz, far above what the human ear can hear – which is a range from 20 hertz to 20 kilohertz. Other products use ultrasound to deliver targeted sound, for instance allowing a museum to play a recording for visitors in one area of an exhibit without disturbing others nearby. Electronic pest repellents use ultrasound to keep rodents or insects at bay. A similar product can even be used to disperse teenagers; aging tends to reduce people’s ability to hear higher frequency sounds, so a noisemaker can annoy young people without adults even noticing. (This has also let teens create smartphone ringtones their elders can’t hear.)

2. What can go wrong with ultrasound?

Airborne ultrasound is not inherently bad. But things can go wrong. A former colleague of Kevin’s used to hear strange sounds from his hearing aid when in rooms with occupancy sensors, likely because the hearing aid’s electronics improperly converted the ultrasound into audible noises. These noises were annoying, but not harmful. A similar problem tainted one of our students’ research, conducted in a room that, unbeknownst to him, had an ultrasonic room occupancy sensor in the ceiling.

3. Should people worry about ultrasound causing bodily harm?

It’s well-known that sounds that are too loud can damage people’s ears and hearing. However, there’s little evidence of ultrasound causing bodily harm without prolonged, direct physical contact at high intensity. If you are accidentally subjected to extremely intense ultrasound (such as when holding an ultrasonic arc welder), you could experience an annoyance like a headache or temporary loss of balance. Academics disagree about safe levels of airborne ultrasound. The U.S. Occupational Safety and Health Administration warns of potential health risks from audible subharmonic byproducts of ultrasound, more so than the ultrasound itself. Many animals can hear higher frequencies than humans. Dogs can hear higher-pitched whistles, for instance. One of our students noticed that his pet turtles would begin to dance rhythmically when he performed ultrasound experiments!

4. What might have happened in Cuba?

In early 2017, U.S. diplomats in Cuba reported hearing strange metallic sounds, and suffering hearing loss and other neurological harm. Later reports of similar effects came from Canadian diplomats and tourists from both Canada and the U.S. Possible explanations have varied: Some have alleged Cuba used an unknown sonic weapon, while others have blamed “mass hysteria.”

Our research offers a new explanation not previously considered by others: The true cause could have been equipment trying to listen in on the diplomats’ and visitors’ conversations. We were able to use ultrasonic tones to create sounds like those that were described and recorded in Cuba. No single ultrasonic tone would do this, but as with musical combination tones, combining more than one can create audible byproduct sounds, including by accident.

A recording of the sound some U.S. Embassy workers heard in Havana.

Further, we created a proof-of-concept eavesdropping device that would record audible conversations and transmit the recordings to a nearby surveillance team over an inaudible ultrasonic link. When we placed a second inaudible ultrasonic device in the area, we were able to create interference – technically called “intermodulation distortion” – between the two signals that made similar sounds to those recorded in Cuba. We were even able to control the volume of the audible sounds by varying the strength of the ultrasonic signals. Without additional evidence, our research does not identify what actually happened in Cuba, but it provides a plausible explanation for what might have happened, even if the eavesdroppers were not trying to harm people.

The University of Pennsylvania’s Center for Brain Injury and Repair was selected to coordinate the evaluation, treatment and rehabilitation of 21 government personnel (11 women and 10 men) identified by the State Department and evaluated an average of 203 days following exposure to reported sound (described as “buzzing,” “grinding metal,” “piercing squeals” or “humming”) and sensory phenomena (described as pressure-like or vibrating and likened to air “baffling” inside a moving car with the windows partially rolled down) at the US Embassy in Havana, Cuba in late 2016.

“Of the 21 individuals assessed at Penn, 17 reported cognitive or behavioral problems such as difficulty remembering, concentrating, or both. “It’s not that any patient can’t do a given task, but it requires way more effort,” said coauthor Randel Swanson, DO, PhD, a brain injury rehabilitation specialist at the University of Pennsylvania’s Center for Brain Injury and Repair. “They don’t have as much cognitive reserve.”

The author and his coauthors signed a nondisclosure agreement with the State Department, “so they cannot discuss whether they know more about what happened in Havana than has already been made public.”

The study concludes that “The unique circumstances of these patients and the clinical manifestations detailed in this report raise concern about a new mechanism for possible acquired brain injury from an exposure of unknown origin.”

On January 10, the State Department issued solicitation #19AQMM18Q0014 for radiation dosimeters. The small business set-aside firm-fixed price contract is for a base year minimum order quantity/quarter of 450 units, and a maximum order quantity/quarter of 475 units, with four option years of the same minimum/maximum requirements. So 1900 units for the base year or 9500 units total in five years. The order is solicited on behalf of Diplomatic Security’s Office of Security Technology (DS/C/ST):

The Government requies a wearable device that records exposure to ionizing radiation that does not contain electronic equipment. It is anticipated that the device will be returned to the vendor for reading and reporting back to the Government the amount of radiation exposure recorded on the device (see Radiation Survey Results Report for more information on the reporting deliverable).

The anticipated order quantity is up to 475 devices. The anticipated ordering frequency is quarterly. No less than 450 devices will be ordered per quarter.

Delivery of the device is required 30 days from award of the BPA call to the X-Ray Program Manager (to be identified upon BPA award).

Radiation Survey Results Report: Radiation survey results reports are to be delivered to the X-Ray Program Manager (to be identified upon BPA award) within 30 days of receipt of returned device for those devices with a reading of over 50 milliRem (mR). Electronic copies of the report will be accepted, and is preferred, and electronic archiving options are also acceptable and preferred.

*

The Department of Homeland Security (DHS) did a survey on radiation dosimeters back in 2015 and established the System Assessment and Validation for Emergency Responders (SAVER) Program to assist emergency responders making procurement decisions. Here is what it says about dosimeters:

Dosimeters are radiation safety devices worn to quantify an individual’s accumulated radiation dose incurred from external sources to evaluate the potential for harmful health effects of radiation. Dosimeters differ from other radiation detection devices that are designed for the purpose of preventing a radiological release by alerting a responder to the presence of radiation.

It appears from the State Department solicitation description that they are looking for processed dosimeters (and not self-reading dosimeters or electronic personal dosimeters, the latter generally the most expensive, largest in size, and most have visual, auditory, or vibratory alarms). Below is what DHS says about processed dosimeters:

Processed dosimeters are based on thermoluminescence (TL), optically stimulated luminescence (OSL), or direct-ion storage (DIS) technologies. Thermoluminescence dosimeters (TLDs) and OSL materials contain defects in their crystal structure that trap electrons released by exposure to radiation. In TLDs, the trapped electrons are subsequently freed by stimulation with heat, while OSL uses stimulation with light. In both types, after stimulation, the resulting light emission provides a measure of the radiation dose received. Specialized equipment is used for this readout, either by the user with field-portable or lab-based equipment, or by a dosimetry processing laboratory. A commercial dosimetry service can be contracted to supply dosimeters on a regular basis, read out returned dosimeters, and provide dose tracking and record keeping. TLDs and OSL dosimeters are offered in either a clip-on brooch format or identification card style. DIS devices use an analog memory cell inside a small, gas-filled, ionization chamber. Incident radiation causes ionizations in the chamber wall and in the gas, and the charge is stored for subsequent readout. The DIS dosimeter is read at the user’s site through connection to a web-based system via a universal serial bus (USB) port or Bluetooth connection to a computer or smart phone. The DIS dosimeter is designed to clip to a breast pocket. Processed dosimeters are also considered passive devices in that they do not have an on/off switch, though DIS devices do contain a small inaccessible battery to maintain their charge or for communications. Processed dosimeters are widely used in health and safety programs for radiation workers such as nuclear

Also this:

The purpose of a dosimeter is for worker protection. The potential hazardous effects of radiation depend on the radiation level. For very high doses (hundreds of R), the effects are immediate (“acute”) such as blood and skin damage or infertility, and the severity of the effect increases with dose.4 For lower radiation levels, the effects are not immediately life threatening; the long term accumulated dose is of interest because the probability (but not the severity) of effects such as cancer increase with dose.

Radiation dosimeters are routinely used in occupational radiation environments in the nuclear industry and at medical facilities. In contrast, except for some hazardous material response teams, most emergency responders do not routinely use radiation dosimeters. Responders may need dosimeters in the event of a radiological release such as a terrorist attack involving a radiological dispersal devise or an improvised nuclear device. Since emergency response scenarios span a wide range of potential radiation levels that could be initially unknown, many factors must be considered in the selection of a radiation dosimeter.

The State Department solicitation notes that the Radiation Survey Results Report are to be delivered to the X-Ray Program Manager within 30 days of receipt of returned device for those devices with a reading of over 50 milliRem (mR). More from DHS’s market survey report:

One of the most important factors influencing selection of radiation dosimeters is the magnitude of radiation levels that an instrument can measure – for example, a very sensitive device with a low minimum range is useful for alerting users to the presence of radiation but may go off-scale and not function in a high radiation field. The operational range of a dosimeter will determine how it can be used during the response, and several guidance documents provide reference values that help define what ranges are applicable. For example, the National Council on Radiation Protection and Measurements (NCRP) defined radiation control zone perimeters for emergency response to nuclear and radiological terrorism, where the “cold zone” is the area where the exposure rate is less than or equal to 10 mR/h, the “hot zone” is an area with exposure rate greater than 10 mR/h, and the “dangerous-radiation zone” is at 10 R/h and higher. Accumulated dose guidelines have also been developed by the Environmental Protection Agency (EPA) and the NCRP to guide tactical emergency response decisions, such as 10 rem for property protection operations and 25 rem and higher to conduct lifesaving missions, 5 or 50 rad to decide whether to withdraw from a radiation area.
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The ability to alarm or display instant results may be an important feature to consider in relation to the magnitude of radiation levels. For example, in a dangerous radiation field, a high range electronic device that can measure exposure rates with a real-time display and alarms could help a responder avoid potentially life threatening doses. In a lower radiation field, self-reading and field-readable processed dosimeters could be used to provide near real-time information. In both types of fields and during intermediate and late phase recovery operations, processed personal dosimeters could be used for later verification of field instrument readings and to track accumulated dose for long term health.

Commission Increased Award of Damages to $60,000. The Commission previously affirmed the Agency’s finding that it failed to reasonably accommodate Complainant. Following an investigation of Complainant’s claim for damages, the Agency awarded Complainant $10,500 in non-pecuniary damages. On appeal, the Commission affirmed the Agency’s decision not to award pecuniary damages, finding insufficient documentary proof to support such an award. The Commission, however, increased the award of non-pecuniary damages to $60,000. The Agency conceded that Complainant established a nexus between the harm he sustained and the discrimination. The record evidence confirmed that over a three-year period, Complainant experienced an exacerbation of his pre-existing conditions caused by stress created by the Agency’s discriminatory actions. Complainant stated that he experienced anxiety, irritability, insomnia and loss of consortium, and indicated that he did not go out socially. He also noted that he experienced headaches, and night sweats, and was forced to increase his medication when the Agency refused to accommodate him. The evidence supported Complainant’s assertion that his condition had stabilized prior to the discrimination, and the Agency was liable for the worsening of Complainant’s condition. Irvin W. v. Dep’t of State, EEOC Appeal No. 0120141773 (Oct. 28, 2016).

At the time of events giving rise to this complaint, Complainant worked as an Information Management Specialist at the Agency’s U.S. Mission to NATO in Brussels, Belgium. On September 11, 2009, Complainant filed an EEO complaint alleging that the Agency discriminated against him on the basis of disability (Sjogrens Syndrome, Rheumatoid Arthritis and Anxiety) when the Agency failed to provide him with a reasonable accommodation of his disability. After an investigation, Complainant requested the Agency issued a final decision. In its decision, the Agency found Complainant established he was subjected to discrimination when he was denied an accommodation. As relief, the Agency ordered that Complainant be provided with a reasonable accommodation. On July 14, 2011, Complainant appealed the decision, and we affirmed the Agency’s finding on liability, and remanded the matter to the Agency so that it could conduct a supplementary investigation into Complainant’s entitlement to compensatory damages. After conducting an investigation, the Agency issued its decision on March 12, 2014 awarding Complainant $10,500.00 in non-pecuniary damages. Specifically, the Agency found that Complainant’s pre-existing condition was largely the cause of Complainant’s physical and emotional distress during this time, and that the amount awarded was meant to compensate Complainant for the worsening of that condition. The Agency disagreed with Complainant’s claim that his condition had stabilized by the time he arrived in Brussels, as evidence revealed he was still on a large dosage of steroids in July 2008, weeks before he began working. Although Complainant alleged that he suffered from a loss of bone density (Osteopenia) as a result of his long term steroid use, the Agency determined that there was insufficient evidence that this was as a result of the discrimination. Furthermore, although Complainant suffered emotional distress related to the discrimination, such distress occurred prior to his request for reasonable accommodation, which the Agency could not be held liable for. In sum, the Agency concluded that Complainant’s condition was inherently unpredictable, and accordingly, his symptoms were unrelated to the discrimination itself. Accordingly, the Agency concluded that $10,500.00 was an appropriate amount to compensate Complainant for the emotional distress he suffered. The Agency declined to award any pecuniary damages in response to Complainant’s request. This appeal followed.
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Based upon the evidence provided by Complainant, we find the Agency’s award of $10,500.00 to be inadequate to remedy the harm caused by the Agency. The Commission notes that record evidence confirmed that over a three year period, Complainant experienced an exacerbation of his pre-existing conditions for which he sought treatment caused by the stress created by the Agency’s discriminatory actions. Complainant asserts that he suffered from anxiety, irritability, insomnia, and loss of consortium. He maintains he did not go out socially, and suffered from headaches, night sweats and loss of bone density. Most notably, he states he had tapered down his steroid dosage prior to reporting to Brussels, but was forced to increase the medication when the Agency refused to provide him with an accommodation of his disability. We find the evidence supports Complainant’s position that his condition had stabilized and thus, the Agency is liable for the worsening of his condition. The Commission finds that an award of $60,000.00 is reasonable under the circumstances. See Complainant v. Dep’t of Transp., EEOC Appeal No. 0720140022 (Sept. 16, 2015) (Complainant awarded $60,000.00 where Agency’s failure to accommodate resulted in depression, anxiety, sleeplessness, and exacerbation of existing symptoms); Complainant v. Soc. Sec. Admin., EEOC Appeal No. 0720130013 (Aug. 14, 2014) (Complainant awarded $60,000.00 where Agency’s failure to accommodate resulted in exacerbation of post-traumatic stress disorder, depression, stress, and elevated blood pressure); Henery v. Dep’t of the Navy, EEOC Appeal No. 07A50034 (Sept. 22, 2005) ($65,000.00 awarded where Complainant suffered from frustration, negativity, and loss of sleep for a four-year period, as well as physical pain associated with the resulting excessive walking. The discrimination caused significant increase in Complainant’s need for medical treatment, as well as an increase in physical and emotional harm). The Commission finds that this amount takes into account the severity of the harm suffered and his pre-existing condition, and is also consistent with prior Commission precedent. Finally, the Commission finds this award is not “monstrously excessive” standing alone, is not the product of passion or prejudice, and is consistent with the amount awarded in similar cases. See Jackson v. U.S. Postal Serv., EEOC Appeal No. 01972555 (Apr. 15, 1999) (citing Cygnar v. City of Chicago, 865 F. 2d 827, 848 (7th Cir. 1989)).